ETOPS operation officially began in 1985 with the newly issued ETOPS criteria (based on section 121.161 from the United States operational regulation 14 CFR Part 121). Along the years, flight under ETOPS rules has proven to be routine, safe and highly successful around the world. One reason for the ETOPS safety-related success is the additional maintenance requirements. This article demonstrates and describes the additional tasks for ETOPS operations. It is also discussed the importance of ETOPS maintenance tasks and the contribution it brings for a safer operation.